In ancient Greece, people would journey to an oracle, or fortune teller,
to discover what the future held. The oracle would kill an animal,
perhaps a goat or a sheep, to examine the creature’s liver. A dark red
liver that was smooth was a good sign. A pale liver that was bumpy
foretold bad times ahead.
The liver has long been linked to human courage and strength.
The earliest doctors thought that the liver was one of the three
main organs of the body. The others were the heart and the brain.
Around a.d. 200, the famous Roman doctor Galen declared the liver
to be the most important human...

o other branch of digestive surgery has undergone the profound changes that have
taken place in hepatic surgery in recent years, especially as a result of the application
of functional segmental liver anatomy and intraoperative ultrasound in resective
surgery. At the same time, the extraordinary progresses achieved in medical oncology
together with the close cooperation between surgeons and oncologists has led to
a watershed in this field of medicine, especially with respect to colorectal liver
metastases.

Indirect standardization is more appropriate for rare outcomes than direct
standardization, resulting in the calculation of rates (McMichael and Giles, 1988). A
limitation of this study is that we did not have access to information on potentially
important risk factors such as lifestyle.
Results for all causes of deaths were significantly lower compared to the autochthon
German population. Overall SMR is reduced for the Aussiedler, therefore, they seem to be
healthier or more resistant than the Germans and therefore they are much healthier than
populations of countries from the FSU....

Sustainable urban development requires an integrated approach and the Thematic
Strategy advocates that national and regional authorities support municipalities in
achieving more integrated management at the local level. This approach is
supported by both of the Council and the European Parliament5.
Integrated approaches include long-term strategic visions and link different policies
at different administrative levels to ensure coherency.

Cancer is the leading cause of death among women aged 35 to 54. As
childbearing among older parturients increases, so likely will the incidence of
cancer in pregnancy. Currently, cancer complicates one in 1000 pregnancies. The
management of pregnant women with cancer presents a major challenge to the
care-giving team: the risks and benefits of treatment (and withholding treatment)
must be weighed for both the mother and the fetus.

In recent years, in other disciplines as well, countries
worldwide have been conducting large national studies
targeting people. It is thought that each country
intends to collect information about the people in these
studies as part of its national strategy and accumulate
it as intellectual property for the health and medical
care of future generations. The United Kingdom,
for example, is conducting research to determine the
effects of lifestyle, the environment, and genetics,
targeting 500,000 adults.

The practicing radiologist is continually challenged to update his/her competencies so
as to deliver state-of-the-art radiological care. Nowhere is this truer than in the rapidly
evolving world of magnetic resonance imaging, where innovations in both technology
and diagnostic pharmaceuticals have dramatically altered the landscape of practice.

Forty years ago, just prior to the discovery of the hepatitis B surface
antigen, the concept that chronic liver disease could be a sequel to infection
by any agent of acute viral hepatitis was controversial and hotly debated. With
the development of specific and sensitive serologic and virologic markers of
infection by the bloodborne and enterically transmitted hepatitis viruses, the
linkage of the former agents with chronic hepatitis, cirrhosis, end-stage liver
disease, and hepatocellular carcinoma was established beyond doubt....

Diagnosis
(Fig. 46-1) Hyponatremia is not a disease but a manifestation of a variety of disorders. The underlying cause can often be ascertained from an accurate history and physical examination, including an assessment of ECF volume status and effective circulating arterial volume. The differential diagnosis of hyponatremia, an expanded ECF volume, and decreased effective circulating volume includes congestive heart failure, hepatic cirrhosis, and the nephrotic syndrome.

Death and Dying The most common causes of death in patients with cancer are infection (leading to circulatory failure), respiratory failure, hepatic failure, and renal failure. Intestinal blockage may lead to inanition and starvation. Central nervous system disease may lead to seizures, coma, and central hypoventilation. About 70% of patients develop dyspnea preterminally. However, many months usually pass between the diagnosis of cancer and the occurrence of these complications, and during this period the patient is severely affected by the possibility of death. ...

Fever Fever in a traveler who has returned from a malarious area should be considered a medical emergency because death from P. falciparum malaria can follow an illness of only several days' duration. Although "fever from the tropics" does not always have a tropical cause, malaria should be the first diagnosis considered. The risk of P. falciparum malaria is highest among travelers returning from Africa or Oceania and among those who become symptomatic within the first 2 months after return.

Differential Diagnosis The differential diagnosis between DIC and severe liver disease is challenging and requires serial measurements of the laboratory parameters of DIC. Patients with severe liver disease are at risk for bleeding and manifest laboratory features including thrombocytopenia (due to platelet sequestration, portal hypertension, or hypersplenism), decreased synthesis of coagulation factors and natural anticoagulants, and elevated levels of FDP due to reduced hepatic clearance. However, in contrast to DIC, these laboratory parameters in liver disease do not change rapidly.

Today, computed tomography (CT) is the most commonly
used imaging method in the assessment of pancreatic
tumors. The sensitivity of CT in detection of pancreatic
tumors is more than 90% when direct and indirect signs
are used for diagnosis. However, the potential to differentiate
exocrine (non-endocrine) tumors of the pancreas
is limited. CT is used in these lesions to perform an adequate
staging, especially for surgical purposes. The
operative resectability, primarily in regard to vessels,
lymph node metastasis and hepatic metastasis, has to be
assessed....